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Optimising Return to Work for Cardiovascular Patients: An Interdisciplinary Approach in Occupational Medicine and
Donatella Sansone1, Antonella Cherubini2, Fabiano Barbiero3
1UOC Unit of Occupational Medicine, Department of Medical Sciences, University of Trieste, 34129 Trieste, Italy.
Insights
Returning to work after cardiovascular events is complex. Factors like self-employment and job demands influence return-to-work timelines, highlighting the need for integrated care.
Area of Science:
- Cardiology
- Occupational Medicine
- Rehabilitation Medicine
Background:
- Investigated facilitators and barriers to return to work (RTW) post-cardiovascular events or surgery.
- Integrated clinical, functional, and occupational factors in the analysis.
Purpose of the Study:
- Identify predictors of timely return to work after acute cardiovascular events or cardiac surgery.
- Explore the interplay between health status, work characteristics, and RTW.
Main Methods:
- Prospective cohort study of 103 employed adults aged 18-67.
- Collected sociodemographic, clinical, occupational, functional (Work Ability Index), and quality of life (EQ-5D-5L) data.
- Utilized Cox regression models to analyze RTW predictors.
Main Results:
- 77.7% of patients returned to work (mean 58.9 days).
- Earlier RTW associated with self-employment, occupational responsibility, and percutaneous coronary intervention.
- Delayed RTW linked to high physical job demands, arrhythmias, and cardiac rehabilitation participation.
Conclusions:
- Return to work after cardiovascular events is multifactorial.
- Occupational medicine integration into cardiac rehabilitation is crucial for safe and sustainable reintegration.
- Functional status and quality of life were generally preserved post-event.
Abstract:
Background: This study explored facilitators and barriers to return to work (RTW) after acute cardiovascular events or elective cardiac surgery, integrating clinical, functional, and occupational factors. Methods: A prospective cohort study was conducted at the Occupational Medicine and Cardiac Rehabilitation Units of the Maggiore Hospital in Trieste, Italy. Employed adults (18-67 years) admitted for acute coronary syndrome, valve replacement, or thoracic aortic surgery between January 2024 and July 2025 were enrolled. Sociodemographic, clinical, and occupational data were collected alongside functional and psychosocial assessments, including the Work Ability Index (WAI) and EQ-5D-5L. Predictors of RTW were analyzed with Cox regression models. Results: Among 103 patients (mean age 56.8 years; 92.2% male), 77.7% returned to work after a mean of 58.9 days. Independent predictors of earlier RTW were self-employment (HR 5.08, 95% CI 2.52-10.27), occupational responsibility (HR 2.12, 95% CI 1.01-4.45), and percutaneous coronary intervention (HR 2.72, 95% CI 1.47-5.06). Higher job-related physical demands, arrhythmias, and cardiac rehabilitation participation were associated with delayed RTW. Mean WAI (37.2 ± 5.1) and EQ-5D index (0.92 ± 0.09; EQ-VAS 77.4 ± 12.9) indicated preserved function and quality of life. Conclusions: RTW after cardiovascular events is multifactorial. Integrating occupational medicine into cardiac rehabilitation is key to ensuring safe, sustainable reintegration.
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